CPT® Code 31626

Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple

The procedure described by CPT® Code 31626 involves the use of a bronchoscope, which can be either rigid or flexible, to place fiducial markers in the lungs. Fiducial markers are small, typically gold, markers that are strategically positioned within or near a tumor to assist in the precise targeting of radiation therapy, particularly in stereotactic radiosurgical treatments. The bronchoscope is introduced through the patient's nose or mouth and navigated through the oropharynx, allowing for a thorough examination of the airway structures. Fluoroscopic guidance may be utilized during the procedure to enhance visualization and accuracy. The examination includes the vocal cords and the trachea, followed by the right and left mainstem bronchi, where any abnormalities can be documented. If a rigid bronchoscope is employed, additional visualization tools such as a telescope or a flexible bronchoscope may be inserted to inspect the distal segments of the bronchi more effectively. The fiducial markers are placed using a specialized transbronchial needle, which consists of a needle and a sheath. This needle is carefully maneuvered through the bronchoscope to the targeted tumor site, where the fiducial marker is deployed. The process is repeated for each marker until the desired number of fiducial markers has been successfully placed, ensuring optimal positioning for subsequent treatment planning.